Provider Demographics
NPI:1437164282
Name:VILLAGE OF CALUMET PARK
Entity Type:Organization
Organization Name:VILLAGE OF CALUMET PARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTISTELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-233-1170
Mailing Address - Street 1:PO BOX 438495
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-8495
Mailing Address - Country:US
Mailing Address - Phone:773-233-1170
Mailing Address - Fax:773-233-8146
Practice Address - Street 1:12409 S THROOP ST
Practice Address - Street 2:
Practice Address - City:CALUMET PARK
Practice Address - State:IL
Practice Address - Zip Code:60827-5819
Practice Address - Country:US
Practice Address - Phone:773-233-1170
Practice Address - Fax:773-233-8146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL786003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016-70820OtherBCBS
IL016-70820OtherBCBS
IL749540Medicare ID - Type Unspecified